What Are the Symptoms of Uterine Polyps?

Keeping an Eye Out for This Mostly Asymptomatic Issue

Uterine polyps
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Almost a quarter of all women experience uterine polyps, an overgrowth of tissue in the endometrium. While many women experience abnormal uterine bleeding, the fact is that uterine polyps are often asymptomatic.

Uterine polyps, also called endometrial polyps, are usually small, bulb-shaped masses of endometrial tissue attached to the uterus by a stalk. They are soft, as opposed to uterine fibroids, which can grow much bigger and are made of hard muscle.

Symptoms of Uterine Polyps

When symptoms of uterine polyps are apparent, they're similar to those of more serious conditions, such as endometrial cancer. If you have these symptoms it's important that you see a doctor. The symptoms may include several types of abnormal uterine bleeding such as:

Who Is at Risk?

The exact cause of uterine polyps is unknown, but they are sensitive to the hormone estrogen. You may be more likely to develop polyps if you are:

Fewer than one percent of all uterine polyps are associated with cancer.

Uterine Polyps and Infertility

Infertility is defined as the inability to conceive after one year of trying. When a woman is infertile and has no symptoms of uterine polyps, the chance that she has asymptomatic polyps is between three percent and five percent, according to the Jones Institute of Reproductive Medicine.

If she's experiencing abnormal bleeding, it's more likely that polyps are present.

Uterine polyps can act like a natural intrauterine device (IUD), preventing a fertilized egg from implanting in the uterine wall. They can also block the area where the fallopian tube connects to the uterine cavity, preventing sperm from traveling into the tube to meet the egg.

Similarly, they can block the canal of the cervix, which would prevent sperm from entering the uterus at all. Polyps may also play a role in miscarriage for some women.

In a study published in 2005 in the Journal of Human Reproduction, women undergoing artificial insemination after having their polyps removed became pregnant at about twice the rate of women who did not have their polyps removed. In fact, the women who had their polyps removed often became pregnant without artificial insemination.

Diagnosis and Treatment

Your doctor may recommend one of several methods for finding out whether you have uterine polyps:

Hysterosalpingogram (HSG). An exam using an x-ray, in which a radiologist injects a contrast dye into the uterus and fallopian tubes to make it easier to see polyps and other tissue.

Ultrasound. Insertion of a wand-like device into the vagina that sends out high-frequency sound waves to create images.

Sonohysterogram. A special type of ultrasound in which the radiologist fills the uterine cavity with saline using a narrow catheter.

The saline distends the cavity (like a balloon) and creates a space between the walls. This aids in visualizing polyps that may be missed with traditional ultrasound.

Hysteroscopy. A procedure using a scope inserted through the vagina into the uterus to view the polyps and determine their size and extent. Part or all of a polyp can also be removed for microscopic examination by inserting instruments through the hysteroscopic tube.

Excision through traditional methods. A sample of a polyp may be obtained through curettage (scraping or scooping) or biopsy (removing tissue via an instrument resembling a drinking straw), or after a hysterectomy (removal of the uterus).

Examination of tissue under a microscope is the only way to reliably determine whether a polyp is benign (noncancerous) or malignant (cancerous).

Some polyps disappear on their own. When removal is necessary to control bleeding, to increase pregnancy odds, or to check for cancer, curettage guided by a hysteroscope is often recommended. A more conventional method, dilation and curettage (D&C), or scraping the uterine lining, is also still in use.

Hysteroscopy is generally performed using either local or no anesthesia, but general anesthesia is sometimes used as well. After hysteroscopy, you may experience slight bleeding and mild cramps, but you should be able to resume normal activities right away, with the possible exception of intercourse, which you may need to avoid for a week or two if your doctor advises.

When polyps are too numerous for hysteroscopic removal, a hysterectomy may be recommended.

There is no specific method for preventing uterine polyps, although keeping yourself at a healthy weight and watching your blood pressure are the best methods of lessening your risk factors.

Sources:

"Defining Overweight and Obesity." cdc.gov. 20 Jun. 2008. Centers for Disease Control. 20 Jan. 2009.

Dreisler, Eva, Soren S. Sorenson, and Gunnar Lose. "Endometrial Polyps and Associated Factors in Danish Women Aged 36-74 Years." American Journal of Obstetrics & Gynecology 200:2(2008): 147. 20 Jan. 2009.

"Endometrial Conditions." frankfordhospitals.org. 2008. Frankford Hospitals. 20 Jan. 2009.

"Endometrial Polyps." umich.edu. 2006. University of Michigan. 20 Jan. 2009.

Giordano, Giovanna, Letizia Gnettia, Carla Merisio, and Mauro Melpignano. "Postmenopausal Status, Hypertension and Obesity as Risk Factors for Malignant Transformation in Endometrial Polyps ." Maturitas 56:2 (2007):190-197. 20 Jan. 2009.

"Hysteroscopy." stjohnsmercy.org. 2009. St. John's Mercy Health Care. 20 Jan. 2009.

"Infertility -- Uterine Factor." jonesinstitute.org. 2006. The Jones Institute for Reproductive Medicine. 20 Jan. 2009.

McGurgan, P., L.J. Taylor, S.R. Duffy, and P.J. O'Donovan. "An Immunohistochemical Comparison of Endometrial Polyps From Postmenopausal Women Exposed and Not Exposed to HRT." Maturitas 53:4 (2006):454-461. 20 Jan. 2009.

"Pathology Report: Endometrial Polyps." cap.org. 1 April 2005. College of American Pathologists. 20 Jan 2009.

Perez-Medina, Tirso, Jose Bajo Arenas, Francisco Salazar, Teresa Redondo, Luis Sanfrutos, Pilar Alvarez, and Virginia Engels. "Endometrial Polyps and Their Implication in the Pregnancy Rates of Patients Undergoing Intrauterine Insemination: A Prospective, Randomized Study." Human Reproduction 20 (2005):1632-1635. 20 Jan. 2009.

"Sonohysterogram." dhmc.org. 2009. Dartmouth-Hitchcock Medical Center. 10 Feb. 2009.

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